Provider Demographics
NPI:1841796042
Name:OLI, SHARAD
Entity Type:Individual
Prefix:
First Name:SHARAD
Middle Name:
Last Name:OLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E CENTER ST APT 101
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-3819
Mailing Address - Country:US
Mailing Address - Phone:507-319-3670
Mailing Address - Fax:
Practice Address - Street 1:MAIMONIDES MEDICAL CENTER
Practice Address - Street 2:4802 10TH AVENUE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219
Practice Address - Country:US
Practice Address - Phone:718-283-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program